In a previous article, I discussed the recent changes to mammography recommendations.  This week I’ll share what women can do to reduce their risk of breast cancer.

First of all, it is important to acknowledge that cancer statistics are very complicated; the most recent research study may have results that contradict the one before.  This explains why it is easy to get confused by the divergent information about cancer in the news media.  I will try to provide some clarity.

Put simply, being at a healthy weight significantly reduces the risk of dying from breast cancer.  Numerous medical studies indicate that maintaining a health weight (BMI between 20 and 25) is the most important lifestyle factor in affecting breast cancer survival.

The healthiest way of achieving optimal weight is to eat plenty of vegetables and fruits and to exercise regularly.  A 2007 study published in the Journal of Clinical Oncology indicates that breast cancer patients who eat these healthy foods and exercise reduce their risk of dying from their cancer by up to 50%.

While having a glass of wine every day seems to prevent cardiovascular disease and decreases the rate of death from all causes, this amount of alcohol seems to increase breast cancer risk.  If you are concerned about breast cancer because of your personal or family medical history, avoid alcohol.  If cardiovascular disease seems more important, a few glasses of wine can be an enjoyable and healthy choice.

Hormone therapy with estrogen and/or progesterone for menopause increases the risk of women getting breast cancer.  While the increased risk may be small, it is real: a 24% increase in risk.  Natural treatments for menopausal symptoms work well.  Some of the best therapies I recommend include herbs like black cohosh, chaste tree, and St. John’s Wort.  Preliminary research indicates that black cohosh can even be helpful as an add-on treatment for breast cancer.

One of vitamin D’s roles in the body is helping to make sure that cells grow to be healthy and mature.  Because dangerous cancer cells are immature, vitamin D status may be important in all forms of cancer, including breast.  The best way to know your vitamin D level is to get a test from your doctor called 25-OH Vitamin D.  Insufficiency is defined as less than 30ng/mL and optimal levels are about 45ng/mL.  If testing is not available to you, taking 2,000 IU of supplemental vitamin D3 each day is a safe approach.

Be well,
Richard Malik, ND

Many natural healthcare providers work with natural or bio-identical hormones claiming they are safer than common prescription hormones.  Prescription estrogen (also called conjugated estrogens) is obtained from the urine of mares.  Bio-identical estrogens are molecularly the same as human estrogen but are synthesized in laboratories from soy or wild yams.

Progestins are drugs that act like progesterone in the body.  These drugs are patented molecules that do not occur in nature.  They are not progesterone, but they do stimulate progesterone receptors in the body.

Many women experience dramatic improvements in their menopausal symptoms when taking either conjugated or bio-identical hormones.  But, are they safe?

Recent medical studies indicate that conjugated estrogens increase the risk of blood clots and other cardiovascular events like heart attacks and strokes.  They also show that conjugated estrogens (only) when combined with progestins increase the risks of some types of cancer.

The scientific research seems to indicate that bio-identical hormones do not cause the cardiovascular risks that are associated with conjugated estrogens or at the very least do so at a much lower rate.  Here are a couple of studies that show this (1, 2).

What about cancer?  Based upon our best research, conjugated estrogens don’t increase the risk of cancer.  I am not aware of any data or scientific studies that allows us to make the same judgement about bio-identical estrogen.

Here are the important points:

1) conjugated estrogens increase the risk of heart disease, blood clots and strokes

2) bio-identical estrogen does not seem to increase the risk of heart disease, blood clots or strokes.  But, more research needs to be done in this regard.

3) conjugated estrogens do not seem to increase the risk of cancer

4) conjugated estrogens when taken with progestins increase the risk of some types of cancer

5) we do not know the effects of taking bio-identical estrogen alone on cancer risk

6) we do not know the effects of taking bio-identical estrogen in combination with bio-identical progesterone on cancer risk

As a patient, it is important that you know what risks you are taking when choosing whether or not to take hormones for menopausal symptoms.  It is also important to know what questions remain unanswered.  You have the right to make decisions that make sense to you.

If you are aware of any medical research showing the effects of bio-identical estrogens on cancer risk, please forward them to me at doctor@maliknd.com.

This post is a reprint of another blog posting.